Table 6.
Predicted probabilities of the correct treatment, referral, and counseling of children seen by HSAs in districts using the iCCM mobile application and paper tools
| Treatment/ Referral/Counseling |
iCCM mobile application |
Paper tools |
P-value† |
||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|
N |
Weighted % |
95% CI |
N |
Weighted % |
95% CI |
||||||||||
|
Treatment: | |||||||||||||||
| Children with cough and fast breathing, positive mRDT, or diarrhoea who are correctly prescribed all medications (antibiotic, antimalarial drug, or ORS and zinc) for their illnesses |
223 |
69.9 |
62.5, 77.4 |
186 |
64.7 |
58.8, 70.6 |
0.267 |
||||||||
| Children with cough and fast breathing who are prescribed an antibiotic correctly |
73 |
70.8 |
67.9, 73.8 |
53 |
74.6 |
71.1, 78.2 |
0.147 |
||||||||
| Children with fever and positive mRDT who are prescribed an antimalarial drug correctly |
80 |
80.0 |
75.6, 84.5 |
89 |
51.8 |
47.0, 56.7 |
<0.001 |
||||||||
| Children with diarrhoea who are prescribed ORS and zinc correctly |
106 |
66.8 |
56.2, 77.5 |
78 |
68.7 |
60.1, 77.3 |
0.760 |
||||||||
| Children without cough and fast breathing who would have left the HSA without having received an antibiotic |
349 |
97.3 |
94.3,100.0 |
297 |
98.2 |
96.2, 100.0 |
0.561 |
||||||||
|
Referral: | |||||||||||||||
| Children with danger signs needing referral who are referred |
96 |
87.0 |
83.9, 90.1 |
88 |
70.8 |
57.0, 84.6 |
0.010 |
||||||||
|
Counseling: | |||||||||||||||
| Children who need an antibiotic, ORS and zinc, or antimalarial drug who receive the correct first dose in presence of HSA |
223 |
28.5 |
18.2, 38.9 |
186 |
35.5 |
25.6, 45.3 |
0.373 |
||||||||
| Caregivers of children with cough and fast breathing, positive mRDT, or diarrhoea who are counseled on their illnesses |
233 |
29.0 |
19.6, 38.4 |
204 |
46.4 |
33.3, 59.6 |
0.058 |
||||||||
| Cough and fast breathing |
79 |
58.7 |
53.1, 64.2 |
61 |
65.0 |
60.2, 69.8 |
0.155 |
||||||||
| Diarrhoea |
114 |
5.4 |
2.4, 8.3 |
89 |
23.0 |
8.0, 38.0 |
0.014 |
||||||||
| Fever and positive mRDT | 83 |
57.2 |
47.2, 67.2 |
93 |
64.7 | 51.3, 78.2 |
0.374 |
||||||||
iCCM – integrated community case management, HSA – health surveillance assistant, MUAC – mid-upper arm circumference, mRDT – malaria rapid diagnostic test, ORS – oral rehydration salts
*HSAs prescribed antimalarial drugs for less than 0.5 percent of children with fever and negative mRDT. Probabilities adjusted for child characteristics (age and gender), HSA characteristics (gender, highest education level, tenure as an HSA, type and duration since most recent iCCM training, patient case load, and village clinic location), and district characteristics (access to improved water source and median number of years of women’s education) using logistic regression with standard errors clustered at the HSA level.
†Compared against Holm-Bonferroni adjusted significance levels.